Novel Strategies In Ischemic Heart Disease

Electrical Heart Instability Evaluation in Conditions of Diastolic Heart Failure Suffered by Coronary Heart Disease Patients (Diagnostics of Ischemic Heart Disease)

Introduction In 1965 WHO experts singed out coronary heart disease (CHD) in a separate group. It was dictated by the growing epidemic incidence rate and high mortality from disease complications. Besides, it was urgent to take measures to treat the disease. However, the end of the XX century and the beginning of the XXI century […]

Prehospital Thrombolysis: It’s All About Time (Pharmacotherapy of Ischemic Heart Disease) Part 1

Introduction Prehospital emergency care personnel can play a crucial role in the identification and management of patients presenting with ST Elevation Myocardial Infarction (STEMI). Specifically, prehospital thrombolysis by emergency medical personnel such as paramedics/nurses/prehospital doctors has been identified as being a successful and safe approach for the provision of accelerating reperfusion strategies for acute STEMI. […]

Prehospital Thrombolysis: It’s All About Time (Pharmacotherapy of Ischemic Heart Disease) Part 2

Drugs Thrombolytic agents There are a number of thrombolytic agents available, however Tenecteplase (TNK) is the only single-use bolus agent available making it the most suitable for prehospital use. Despite this, the ideal thrombolytic agent currently does not exist. The characteristics of an "ideal thrombolytic agent" are as follows: • Rapid reperfusion (15 – 30 […]

Thrombolysis in Myocardial Infarction (Pharmacotherapy of Ischemic Heart Disease)

Introduction Worldwide around 7 million people suffer myocardial infarctions per year according to White et al. (2008). Around one third of these patients having acute myocardial infarction die within the first hour of having symptoms usually due to fatal arrhythmia. Characteristic ST segment elevation in the 12 lead electrocardiogram (ECG) accompanied by clinical symptoms of […]

Platelet Activation in Ischemic Heart Disease: Role of Modulators and New Therapies (Pharmacotherapy of Ischemic Heart Disease) Part 1

Introduction Ischemic heart disease (IHD) remains the major cause of morbidity and mortality in developed countries, and has joined infectious diseases in developing countries as a leading cause of death (WHO 2008). Decades of research have shown conclusively that a number of determinants operating from early childhood onwards, most of them associated with lifestyle, are […]

Platelet Activation in Ischemic Heart Disease: Role of Modulators and New Therapies (Pharmacotherapy of Ischemic Heart Disease) Part 2

Indications, dosage, and side effects Aspirin is widely used for the primary prevention of ischemic events in patients at risk, as well as secondary prevention of cardiovascular events in patients with IHD and cerebrovascular and peripheral vascular disease. Aspirin is usually administered once a day at a dose between 75-325 mg, with 75-100 mg being […]

Platelet Activation in Ischemic Heart Disease: Role of Modulators and New Therapies (Pharmacotherapy of Ischemic Heart Disease) Part 3

Indications, dosage, and side effects The recommended dose of dipyridamole is 75-100 mg four times daily as an adjunct to warfarin therapy. Dipyridamole is a relatively weak antiplatelet agent on its own and thus is not used for the treatment of IHD. However, dipyridamole has been shown to increase myocardial perfusion and left ventricular function […]

Myocardial Ischemia-Reperfusion/Injury (Pharmacotherapy of Ischemic Heart Disease) Part 1

Introduction Refers to myocardial, vascular, or electrophysiological dysfunction that is induced by the restoration of blood flow to previously ischemic tissue. Tissue damage caused when blood supply returns to the tissue after a period of ischemia. The absence of oxygen and nutrients from blood during the ischemic period creates a condition in which the restoration […]

Myocardial Ischemia-Reperfusion/Injury (Pharmacotherapy of Ischemic Heart Disease) Part 2

Effects of vitamin E versus nitroglycerine on I/R injury Our results demonstrated that a short course of vitamin E treatment induced preconditioning in the hearts. The vitamin E therapy, enhanced contractile, and vascular recovery, and attenuated oxidative stress in cardiac tissue, as demonstrated by the decrease of MDA in cardiac tissue. Moreover, this therapy protected […]

Myocardial Ischemia-Reperfusion/Injury (Pharmacotherapy of Ischemic Heart Disease) Part 3

Vitamin E and platelet function Platelets play a critical role in the pathophysiology of reperfusion (Gawaz, 2004). Platelet function is not static during ischemia-reperfusion. Instead, during ischemia regional platelet aggregability is increased. Systemic and regional platelet aggregability also increases during myocardial reperfusion. The mechanism of these responses is unknown but may be related to regional […]

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